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EP2994183A1 - Masque stabilise - Google Patents

Masque stabilise

Info

Publication number
EP2994183A1
EP2994183A1 EP14726205.9A EP14726205A EP2994183A1 EP 2994183 A1 EP2994183 A1 EP 2994183A1 EP 14726205 A EP14726205 A EP 14726205A EP 2994183 A1 EP2994183 A1 EP 2994183A1
Authority
EP
European Patent Office
Prior art keywords
patient
interface device
cushion
patient interface
cavity
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP14726205.9A
Other languages
German (de)
English (en)
Inventor
Antonio BUGAMELLI
Lauren Patricia CHODKOWSKI
Duon Alex Truong
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Koninklijke Philips NV
Original Assignee
Koninklijke Philips NV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Koninklijke Philips NV filed Critical Koninklijke Philips NV
Publication of EP2994183A1 publication Critical patent/EP2994183A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0605—Means for improving the adaptation of the mask to the patient
    • A61M16/0616—Means for improving the adaptation of the mask to the patient with face sealing means comprising a flap or membrane projecting inwards, such that sealing increases with increasing inhalation gas pressure
    • A61M16/0622—Means for improving the adaptation of the mask to the patient with face sealing means comprising a flap or membrane projecting inwards, such that sealing increases with increasing inhalation gas pressure having an underlying cushion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0666—Nasal cannulas or tubing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0683—Holding devices therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/06—Head
    • A61M2210/0618—Nose

Definitions

  • the present invention generally relates to nasal masks, and, more
  • Typical pressure support therapies are provided to treat a medical disorder, such as sleep apnea syndrome, in particular, obstructive sleep apnea (OSA), or congestive heart failure.
  • a medical disorder such as sleep apnea syndrome, in particular, obstructive sleep apnea (OSA), or congestive heart failure.
  • OSA obstructive sleep apnea
  • a patient interface device including a mask component on the face of a patient.
  • the mask component may be, without limitation, a nasal mask that covers the patient's nose, a nasal cushion having nasal prongs that are received within the patient's nares, a nasal/oral mask that covers the nose and mouth, or a full face mask that covers the patient's face.
  • the patient interface device interfaces the ventilator or pressure support device with the airway of the patient, so that a flow of breathing gas can be delivered from the pressure/flow generating device to the airway of the patient. It is known to maintain such devices on the face of a wearer by a headgear assembly having one or more straps adapted to fit over/around the patient's head.
  • Conventional nasal masks typically are one of two primary configurations. Pillows masks are the most commonly adopted configuration and are typically comprised of two channels projecting directly into the separate nasal cavities of the patient. Mounted atop these two channels are soft, compliant, pillows that seal generally in and around the patient's individual nostrils.
  • these two channels are conjoined in a central manifold which receives that piped pressure from a pressure delivery system to which the mask is coupled.
  • the arrangement of such pillows generally serves to anchor such masks to a patient's face.
  • the second common configuration utilizes a cradle cushion. Attached directly to the central manifold, a cut-out is applied which allows both nostrils to receive pressure while simultaneously sealing on the periphery of the nostril openings and upper lip.
  • This configuration has generally not been received in the market place as well as the pillows mask. Without having pillows to anchor the mask, the mask commonly becomes very unstable.
  • One way to resolve this problem is to add support to the headgear to hold the cushion firmly in place, unfortunately there is a negative connotation with hard or bulky material that is used to create this support.
  • Continued focus on reducing the form factor of the cradle cushion has resulted in further reduction in stability of the mask. As stability reduces, air leakage occurs and patients are forced to apply more strapping force, which significantly reduces the comfort of the mask and compliance for patients.
  • the patient interface device comprises: a cushion defining a cavity therein, the cushion having a first side and an opposite second side; an aperture formed in the second side providing access to the cavity, the aperture having a periphery adapted to sealingly engage about the nostrils of a patient when the cushion is disposed on the face of the patient; and a pair of stabilizing members coupled to, and extending from, the cushion, each stabilizing member being adapted to contact the face of the patient in the adjacent nasal region below the orbital bone ridge in such a manner that strapping forces, which would otherwise be directed near the nares of the patient, are instead concentrated onto the patient's maxilla.
  • the stabilizing members may be disposed on opposite sides of the aperture.
  • Each of the stabilizing members may be integrally formed with the cushion.
  • Each of the stabilizing members may be bounded by a grooved portion which is structured to allow each stabilizing member to articulate with respect to the cushion.
  • the grooved portion may comprise a baffle.
  • the grooved portion may comprise a locally thinned wall section.
  • the stabilizing members may be formed separately from, and selectively coupled to, the cushion.
  • Each stabilizing member may comprise a cavity formed therein.
  • Each cavity may be in communication with the cavity of the cushion and each cavity may be adapted to be inflated by one or both of the applied system pressure and the exhalation pressure of the patient.
  • Each cavity may be filled with one or more of a low durometer gel or foam.
  • the cushion may comprise a generally cradle shaped elongate hollow body and the first side may be is of a generally convex shape and the opposite second side may be of a generally concave shape.
  • the patient interface device may further comprise a generally rigid elongated front portion coupled to the front side of the cushion, the front portion having a first end, an opposite second end and an aperture disposed therebetween, wherein the aperture is adapted to be coupled to a patient circuit and wherein each of the first end and opposite second end may be adapted to be selectively coupled to a headgear for use in securing the patient interface device to the head of a patient.
  • the front portion may be coupled to the front side of the cushion via a hollow articulating portion.
  • the hollow articulating portion may include an inward curved U-shaped portion disposed along an upper portion thereof.
  • FIG. 1 is a front isometric view of an example embodiment of a patient interface device according to the principles of the present invention disposed on the face of a patient and shown schematically connected to a pressure support system;
  • FIG. 2 is a front elevation view of the arrangement of FIG. 1;
  • FIG. 3 is a rear elevation view of the patient interface device of FIG. 1 ;
  • FIG. 4 is a top view of the patient interface device of FIG. 1;
  • FIG. 5 is a side view of the patient interface device of FIG. 1;
  • FIG. 6 is a sectional view of the patient interface device of FIG. 1 taken along line 6-6 of FIG. 3;
  • FIG. 7 is an isometric rear view of the patient interface device of FIG. 1;
  • FIG. 8 is a sectional view of the patient interface device of FIG. 1 taken along line 8-8 of FIG. 5;
  • FIG. 9 is a sectional view similar to the sectional view of FIG. 8 of another embodiment of a patient interface device according to the principles of the present invention.
  • FIGS. 10-13 are sectional views similar to the sectional views of FIGS. 8 and 9 of further embodiments of patient interface devices according to the principles of the present invention.
  • FIGS. 14A-14C are examples of contact areas on a patient's face for
  • FIG. 15A is a top cross-sectional view and FIG. 15B is a side view of a further embodiment of a patient interface device including a maxilla support assembly according to the principles of the present invention; and [22] FIGS. 16A-16B are side views of patient interface devices showing alternative embodiments for the maxilla support assembly of FIG. 15A and 15B.
  • the word “unitary” means a component is created as a single piece or unit. That is, a component that includes pieces that are created separately and then coupled together as a unit is not a “unitary” component or body.
  • the statement that two or more parts or components "engage” one another shall mean that the parts exert a force against one another either directly or through one or more intermediate parts or components.
  • the term “number” shall mean one or an integer greater than one (i.e., a plurality).
  • the term “and/or” shall mean both alternatives (i.e., "and") or just one of the alternatives (i.e., "or”).
  • Embodiments of the present invention provide improved stability to masks used in delivering a flow of a treatments gas to the airway of a patient.
  • Particular exemplary embodiments address constraints in reducing the size of a cradle mask by providing a number of structures which enhance stability and reduce movement of the mask with respect to the face of a patient.
  • FIGS. 1-8 illustrate an exemplary embodiment of a patient interface device
  • patient interface device 10 is shown disposed on the face (not numbered) of a patient and schematically connected to a pressure support system 12 via a patient circuit 14, which communicates gas from pressure support system 12 to patient interface device 10.
  • Patient circuit 14 is any device, such as flexible tubing, that carries the flow of gas from the pressure/flow generator in pressure support system 12 to patient interface device 10.
  • Pressure support system 12 is any conventional ventilation or pressure support system. Examples of such pressure support systems include, but are not limited to, a ventilator, a continuous positive airway pressure (CPAP) device, or a variable pressure device, e.g.
  • CPAP continuous positive airway pressure
  • an auto -titrating device proportional assist ventilation (PAV®) device, proportional positive airway pressure (PPAP®) device, C-FlexTM device, Bi-FlexTM device, or a BiPAP® device manufactured and distributed by Philips Respironics of Murrysville, Pennsylvania, in which the pressure provided to the patient varies with the patient's respiratory cycle so that a higher pressure is delivered during inspiration than during expiration, or other pressure support device.
  • PAV® proportional assist ventilation
  • PPAP® proportional positive airway pressure
  • C-FlexTM device C-FlexTM device
  • Bi-FlexTM device Bi-FlexTM device
  • BiPAP® device manufactured and distributed by Philips Respironics of Murrysville, Pennsylvania, in which the pressure provided to the patient varies with the patient's respiratory cycle so that a higher pressure is delivered during inspiration than during expiration, or other pressure support device.
  • Patient interface device 10 includes a cushion 16 sized and configured to span at least a portion of a patient's face while remaining below the patient's eyes when patient interface device 10 is disposed on the face of a patient, such as shown in FIGS. 1 and 2.
  • Cushion 16 comprises a generally cradle shaped elongate hollow body defining a cavity 18 therein and includes a generally convex shaped front side 20 and a generally concave shaped rear side 22, as shown in the top view of FIG. 4.
  • An opening 24, disposed in rear side 22, provides access to cavity 18.
  • the periphery (not numbered) of opening 24 is adapted to sealingly engage about the nostrils of a patient when patient interface device 10 is disposed on the face of a patient.
  • Patient interface device 10 further includes a generally rigid elongated front portion 28 having a first end 30, an opposite second end 32 and an aperture 34 disposed therebetween which is adapted to be coupled (either directly or indirectly) to patient circuit 14 via any suitable coupling mechanism. As perhaps best shown in the front view of FIG. 2, front portion 28 is wider than body portion 16.
  • a coupling mechanism such as the snap like coupling mechanisms 36 illustrated in the FIGS., is provided at or about each of first and second ends 30 and 32 for selectively coupling patient interface device 10 to a headgear (not shown) used in securing patient interface device 10 to the head of a patient.
  • portion 28 is coupled to rear side 22 of cushion 16 via a hollow articulating portion 40 having an inward curved U-shaped portion 42 (FIG. 6) disposed along an upper portion thereof. It is to be appreciated that such arrangement allows for one or both of cushion 16 and front portion 28 to generally be able to move one or more of up, down, and side- to-side with respect to the other of cushion 16 and front portion 28 via flexure of articulating portion 40.
  • treatment gas received at aperture 34 from pressure support system 12 via patient circuit 14 (as previously discussed) is communicated to cavity 18 within cushion 16 via hollow articulating portion 40. As shown in the example embodiment illustrated in FIGS.
  • patient interface device 10 may be formed from a single integral elastomeric material (e.g., without limitation, silicone). In example embodiments, materials having a durometer in the range of about 30 Shore A to about 60 Shore A have been utilized. It is to be appreciated, that the present invention also contemplates that patient interface device 10 may be formed from multiple components formed from the same or different materials which are then coupled together, either permanently or selectively.
  • a single integral elastomeric material e.g., without limitation, silicone.
  • materials having a durometer in the range of about 30 Shore A to about 60 Shore A have been utilized. It is to be appreciated, that the present invention also contemplates that patient interface device 10 may be formed from multiple components formed from the same or different materials which are then coupled together, either permanently or selectively.
  • cushion 16 further includes a pair of stabilizing members 50 disposed on generally opposite sides of opening 24.
  • each stabilizing member 50 is adapted to contact the face of a patient in the adjacent nasal region generally below the orbital bone ridge in such a manner that strapping forces, which would otherwise be directed near the nares of the patient, are instead concentrated onto the patient's maxilla.
  • FIGS. 14A-14C respectively, show non- limiting examples of different regions or areas of contact A, B, C that embodiments of stabilizing members 50 may make on a patient's face. Region A (FIG.
  • Regions B and C are examples of support areas of lesser size than region A (and therefore generally reduce the profile of the associated mask) and focus more on supporting against downward hose torque.
  • FIGS. 1-8 includes a cavity 52 which, in the embodiment of FIGS. 1-8 is generally inflated by one or both of the applied system pressure and the exhalation pressure of the patient.
  • stabilizing member 50 may be generally filled with a low durometer gel (e.g., ⁇ 10 shore A), foam, or other soft material 54 to modify the stiffness or feel of stabilizing members on the patient's face.
  • a low durometer gel e.g., ⁇ 10 shore A
  • foam e.g., foam, or other soft material 54 to modify the stiffness or feel of stabilizing members on the patient's face.
  • FIG. 10 shows a sectional view of another example patient interface device
  • each of stabilizing members 250 may include one or more baffles/rolls or be comprised of a thinned wall section (with respect to the adjacent wall sections) which allow displacement of each stabilizing member 250 while also providing for such members 250 to return to their original position when no force is applied thereto.
  • FIG. 11 shows a sectional view of yet another example patient interface device 310 having stabilizing members 350 which are selectively coupled to cushion 316 via the interaction of one or more coupling mechanisms provided on each stabilizing member 350 and cushion 316.
  • such coupling mechanisms include a mushroom shaped protrusion 356 which extends from cushion 316 and is engaged by a cooperatively shaped aperture 358 formed in stabilizing member 350.
  • suitable coupling mechanisms may be employed without varying from the scope of the present invention.
  • such arrangement allows for the stabilizing members to be selectively replaced, if needed, or custom tailored to fit a particular patient by changing one or more of the size, texture, hardness, etc. of the stabilizing member.
  • each of stabilizing members 350 includes a hollow cavity 352 in fluid communication with cavity 18 via a channel 360 formed in each mushroom shaped protrusion 356.
  • Such arrangement provides for each cavity 352 to be generally inflated by one or both of the applied system pressure and the exhalation pressure of the patient.
  • FIG. 12 shows a sectional view of a further example patient interface
  • each selectively coupled stabilizing member 450 includes a sealed cavity 452 which is not in communication with cavity 18.
  • cavity 452 may be filled with air of a predetermined pressure in order to provide a selected stiffness for each member 450.
  • each stabilizing member 550 may similarly be generally filled with a low durometer gel, foam, or other soft material 554 to modify the stiffness or feel of the stabilizing members 550 on the patient's face.
  • stabilizing members 50, 150, 250, 350 and 450 are included in the example embodiments of FIGS. 8-13, it is to be appreciated that one or more of the quantity, size or shape of such stabilizing members may be modified without varying from the scope of the present invention.
  • FIGS. 1-8 further includes a number of ridges 60 (FIGS. 6-8) running generally between front side 20 and rear side 22 on the bottom of cushion 16 thus generally connecting the facial contact area to the front portion 28 and the headgear (not shown) coupled thereto.
  • the localized increase in material thickness provides additional stability against patient interface device 10 rocking toward the nares of the patient.
  • FIG. 15A is a top cross-sectional view and FIG. 15B is a side view of a further embodiment of a patient interface device 600 according to the principles of the present invention.
  • patient interface device 600 includes a cushion 610 and stabilizing members 612 provided on each side of the cushion.
  • the patient interface device includes a maxilla support assembly 630 that serves to transfer strapping forces to the maxilla supports, as indicated by arrows A. Maxilla support assembly 630 also helps to maintain the curvature of the cushion, i.e., prevent the cushion from collapsing as the cushion is forced against the face of the user.
  • Maxilla support assembly 630 includes a first portion 632 operatively
  • the maxilla support assembly is intended to be as minimal as possible, and extends from the elbow coupling into a pocket (not shown) within the stabilizing member. The use of maxilla support assembly is particularly helpful in situations where the cushion is formed from a relatively low durometer.
  • the present invention contemplates that any portion of the maxilla support assembly 630 can be provided within the cavity defined by the cushion, provided in the wall of the cushion itself, provided external to the cushion, or any combination thereof.
  • the maxilla support assembly is formed from a sufficiently rigid or semi-rigid material so as to transfer the forces to the stabilizing members.
  • at least a portion of the maxilla support assembly is flexible so as to allow flexing of the cushion as the strapping force is changed.
  • the maxilla support assembly can be formed from a variety of materials and can be either permanently or selectively attachable to the cushion and/or elbow coupling.
  • the various components of the maxilla support assembly can have any one of a variety of sizes, shapes and geometries.
  • FIGS. 16A and 16B illustrate examples of other such configurations for maxilla support assembly 630a and 630b.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Emergency Medicine (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

L'invention concerne un dispositif d'interface patient, qui comprend un coussinet définissant une cavité à l'intérieur de celui-ci, le coussinet ayant un premier côté et un second côté opposé. Une ouverture est formée sur le second côté et fournit un accès à la cavité, l'ouverture ayant une périphérie conçue pour être en prise étanche autour des narines d'un patient lorsque le coussinet est disposé sur le visage d'un patient. Le dispositif d'interface patient comprend en outre une paire d'éléments de stabilisation couplés au coussinet et s'étendant de celui-ci, chaque élément de stabilisation étant conçu pour entrer en contact avec le visage du patient dans la région nasale adjacente sous la crête osseuse orbitale de telle sorte que des forces de sanglage, qui seraient dirigées près des narines du patient, sont concentrées sur le maxillaire du patient.
EP14726205.9A 2013-05-09 2014-04-29 Masque stabilise Withdrawn EP2994183A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201361821370P 2013-05-09 2013-05-09
PCT/IB2014/061069 WO2014181214A1 (fr) 2013-05-09 2014-04-29 Masque stabilise

Publications (1)

Publication Number Publication Date
EP2994183A1 true EP2994183A1 (fr) 2016-03-16

Family

ID=50792483

Family Applications (1)

Application Number Title Priority Date Filing Date
EP14726205.9A Withdrawn EP2994183A1 (fr) 2013-05-09 2014-04-29 Masque stabilise

Country Status (5)

Country Link
US (1) US11298493B2 (fr)
EP (1) EP2994183A1 (fr)
JP (1) JP6396996B2 (fr)
CN (1) CN105188820B (fr)
WO (1) WO2014181214A1 (fr)

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JP2016517758A (ja) 2016-06-20
CN105188820A (zh) 2015-12-23
WO2014181214A1 (fr) 2014-11-13
US11298493B2 (en) 2022-04-12
JP6396996B2 (ja) 2018-09-26
US20160082215A1 (en) 2016-03-24
CN105188820B (zh) 2018-01-02

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